Individual
MRS. REBECCA JEAN FAW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
221 W MAIN ST, JEFFERSON, NC 28640-9723
(336) 246-4542
(828) 262-5687
Mailing address
221 W MAIN ST, JEFFERSON, NC 28640-9723
(336) 246-4542
(828) 262-5687
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4103
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135HJ
BCBS OF NC
NC
01
—
2177617
CIGNA BEHAVIORAL HEALTH
NC
05
—
6102748
—
NC
01
—
C0916
MEDCOST
NC
01
—
N/A
CBHA
NC
Enumeration date
03/02/2006
Last updated
07/09/2007
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